Caring with Communities

“Integration authorities need to shift resources, including the workforce, towards a more preventative and community-based approach. Even more importantly, they must show that this is making a positive impact on service users and improving outcomes.” (Health and Social Care Integration, Audit Scotland. 2015)

At the end of 2015 a report by Audit Scotland on the preparedness of public sector partners to be operating as Integrated Authorities from 1st April 2016 concluded its’ Summary Recommendations with this assertion. So, amongst all the demands of forming Integrated Authorities there is a clear message that everyone involved must be looking towards working models which are community based and focused on prevention.

Indeed, this fits with the narrative in Scotland on the Scottish Approach (..to policy making, and more recently, in relation to evidence) which “seeks to put citizens and community interests at the heart of public policy” (The Scottish Approach to Evidence, Carnegie UK & Alliance for Useful Evidence. 2017).

Between the times of both these reports, three Integrated Authorities have engaged with the National Development Team for Inclusion (NDTI) to see how Community-led Support delivers in relation to placing Health and Social Care at the heart of communities. Both the Scottish Government and Healthcare Improvement Scotland have been alongside this journey, keen to see the impact and whether it embeds a focus on prevention and on utilising community assets. Sharing such evidence will be hugely beneficial to the other twenty eight Integrated Authorities.

Lessons so far

On 16th March 2017 in Edinburgh, the three partnerships (East Renfrewshire, South Ayrshire and Scottish Borders) gave updates on their early experience of adopting the Community-led Support model. The event was co-hosted by Healthcare Improvement Scotland, NDTI and the Guardian Newspaper. It was really encouraging to hear some of the key messages coming through:

• Third sector feedback that while the model brought very real challenges and a level of uncertainty for the immediate future, there was a very strong sense of how positive it was to be at the table and able to exert some influence as the partnership navigates what are in fact shared challenges.
• Public sector feedback indicating that Community-led Support, rather than being something New and Additional, was in fact a way of bringing together existing good practice under an umbrella which simply helps these parts work much better together
• A very real appetite to reduce bureaucracy, and indications that not only was this desirable, it was and is possible, without sudden and unmanageable risk.
• Community voices expressing their hopes and fears and, like the third sector organisations, really pleased to have a voice in the planning conversations and a greater degree of influence than they have previously felt.
• A true sense of collaboration amongst all those involved, both within partnerships but also across all three partnerships and the respective national agencies. In other words Community-led Support is modelling the organisational and individual behaviours that it hopes to engender in local communities

So Community Led Support has started well across the three Integrated Authorities and is already showing the promise of being able to deliver on the goals set out by Audit Scotland and also through the Scottish Approach. All three areas have engaged their local communities effectively and are at varying stages of translating that engagement into a more asset based approach to both Social Care and Health services. But more significantly still, there is evidence of using Community Development and Empowerment and delivering on these agendas offers real opportunity to make the move a sustainable one.